SARS-CoV-2 S gene sequencing in AZD7442 Phase II mAb trial

As part of the ACTIV-2/A5401 randomized clinical trial (NCT04518410), participants with symptomatic SARS-CoV-2 infection were given cilgavimab and tixagevimab or placebo treatment. We performed targeted Spike (S) gene next-generation sequencing to detect cilgavimab and tixagevimab resistance mutations. Using this data, we can assess whether in vivo emergence of SARS-CoV-2 resistance mutations alters viral replication dynamics or therapeutic efficacy in the immune-competent population.